Survey Affidavit (Prior Policy)

STATE OF FLORIDA              )

COUNTY OF ____________  )

            Before me, the undersigned authority, personally appeared ___________________ who, being duly sworn, depose(s) and say(s):

1. Affiant(s) herein reside(s) at _____________________________, and is/are the present owner(s) of: ___________________________________________________________________ which are the same lands described in that certain title insurance policy #,  ______________dated _____________, attached hereto and made a part hereof as Exhibit “A”;
   
   
2. Affiant(s) has/have examined said policy:
   
   
3. As the owner(s) of the land described in said policy, Affiant(s) is/are familiar with the land, buildings(s) and other improvements located upon said land;
   
   
4. EXCEPT  FOR THE  FOLLOWING:

Affiant(s) know(s) that no buildings, fences, driveways or other improvement have been constructed upon the land and to the best of Affiant’s belief and knowledge, there has/have been no buildings, fences, driveways or other improvements constructed upon adjoining land since the date of the aforesaid policy;

             1.
             2.

1. Affiant(s) further state that they are each familiar with the nature of an oath and with the penalties as provided by the laws of the State of Florida for falsely swearing to statements made in an instrument of this nature.  Affiant(s) further certify that they have read, or have had read to them, the full facts of this Affidavit, and understand its context.
   
   
2. This Affidavit is given to induce __________________________________________
                                                                                    (Agency Name)

And Stewart Title Guaranty Company to issue its policy or policies of title insurance covering the above-described premises.

1. Affiant(s) agree to indemnify _________________ and Stewart Title Guaranty Company against any loss, including attorney fees and costs, which may incur as a result of relying upon the representations contained in this affidavit.

 Further Affiant(s) saith not.

                                                      ______________________________________

                                                      (SIGNATURE)

                                                                        _______________________________________________

                                                                        (PRINTED NAME & ADDRESS)

                                                                        _______________________________________________

                                                                        (SIGNATURE)

                                                                        _______________________________________________

                                                                        (PRINTED NAME & ADDRESS)

The foregoing was sworn to and subscribed before me this _____ day of _________, 20___, by _____________________, who is/are personally known to me or who has/have produced ________________________ as identification and who did/did not take an oath.

(SEAL)                                                       

___________________________

(SIGNATURE & PRINTED NAME)        

NOTARY PUBLIC

MY COMMISSION EXPIRES: